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Should Older Physicians Be Forced to Retire? – 7/11/2012

More than 20 percent of physicians in the United States are over the age of 65. That number is expected to rise as the early members of the baby boomer generation reach senior status. With an aging population of doctors, the time has come to consider how advancing age may affect a physician's performance. Do older doctors pose an inherent risk to their patients? And how do you know when it is time to hang up your stethoscope?

With decades of experience under their belt, seasoned physicians have not only honed their skills, but they perform some of the greatest work in the later years of their life. Older doctors have a wealth of knowledge that can only come from examining thousands of patients and treating many varied medical conditions throughout their careers. As such, they serve as a valuable resource for younger, less-experienced physicians.

On the other hand, not even doctors are immune to the effects of aging. While many doctors retain their skills well into their 70s and beyond – eyesight, coordination, and memory frequently decline with advancing age. Doctors with mild cognitive issues may be unaware that their performance has suffered. Such changes are often subtle and may not be noticeable at first, even to a doctor.

Furthermore, older doctors that grow comfortable with their tried-and-true methods are less likely to adopt newer and more effective treatments. They may find it difficult to stay up-to-date with the latest medical technologies and diagnosis recommendations. A study published in the Annals of Internal Medicine suggests that older physicians know less about new treatments and medical advances compared to doctors recently out of medical school.

According to patient interviews, many individuals prefer seeing older doctors because they view them as more trustworthy and knowledgeable than their younger counterparts. Other patients prefer young physicians because their training is more recent, and therefore more advanced.

Although the data is mixed, there is no denying that a doctor’s age may contribute to a higher chance of medical malpractice. According to a 2006 study published in the Annals of Surgery, doctors over the age of 60 were more likely to make surgical errors that resulted in the death of a patient. However, the same study found no difference between older and younger doctors when performing routine operations. According to research conducted in 2005, the rate of disciplinary action taken by a state medical board was 6.6 percent for doctors who had left medical school more than 40 years ago, compared to 1.3 percent for those who had graduated within the past decade.

There are no guidelines to determine when it's time for a doctor to retire. Pilots – like physicians – are responsible for countless lives. Commercial pilots must retire when they reach 65, and are subjected to mental and physical exams twice yearly once they turn 40. However, there exists no similar oversight in the medical industry. Older doctors are so well-respected by younger physicians that forced retirement is a difficult subject to swallow in the healthcare field.

Concerned medical professionals must intervene if they feel a fellow doctor is unable to provide competent medical services. However, it can be difficult to confront a well-respected senior physician about their age and its possible effects on their ability to practice medicine, even if it means compromising patient safety. Oftentimes, an older doctor’s declining medical skills will go unnoticed until they have already made a grave error and are forced to surrender their medical license. By then, it may be too late to prevent the injury or death of a patient.

It is common for doctors to cover for aging colleagues by taking over their cases or providing supervision in the operating room. Some doctors approaching retirement have reduced their caseloads in an effort to wean themselves away from the profession. However, Dr. John Birkmeyer of the University of Michigan – co-author of the study, – suggests that gradual retirement may not be ideal, as frequent practice enables physicians to maintain their skill level.

Some officials have suggested mandatory testing to assess whether aging doctors still have the skills necessary to practice medicine safely. Although a few hospitals have instituted screening for older doctors, this procedure is not widespread. Others argue that such a policy would be unwarranted.

For now, there is no requirement for a doctor to stop practicing medicine at any age. Nevertheless, this oversight could be harming patients by enabling doctors to remain in the medical field past their prime.